guided bone regeneration with titanium membrane a preliminary study
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Guided bone regeneration with titanium membrane : A preliminary study. 길병원 치과 센터. Introduction. Sufficient volume & quality of alveolar bone Esthetics & function in implant dentistry . Guided tissue regeneration.

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guided bone regeneration with titanium membrane a preliminary study
Guided bone regeneration with titanium membrane : A preliminary study

길병원 치과 센터

introduction
Introduction
  • Sufficient volume & quality of alveolar bone
  • Esthetics & function in implant dentistry
guided tissue regeneration
Guided tissue regeneration
  • The use of membranes to guide bony tissue formation by separating the underlying bone from the overlying connective tissue

& by creating a space into which the desirable bone cells can migrate

- by Dahlin C. 1994

indication of gbr
Indication of GBR
  • Extraction site

- Prevention of crestal bone loss

especially when 1 or more wall missing

  • Correction of inadequate ridge width or shape

- Atrophic alveolar bone reconstruction for implant

placement

indication of gbr1
Indication of GBR
  • Dehicence defects
  • Apical fenestration
  • Residual intraosseous defects

- Fresh or incompletely repaired extraction site

historical review of gbr
Historical review of GBR
  • Regeneration of alveolar bone beneath cellulose acetate filler implant

- by Boyne PJ. 1964

  • Healing of bone defects by GTR

- by Dahlin C et al. 1988

historical review of gbr1
Historical review of GBR
  • Bone formation utilizing titanium-reinforced barrier membrane

- by Jovanovic. 1995

  • Augmentation of intramembraneous bone beyond the skeletal envelope using an occlusive titanium barrier

- by Lundgren D. 1995

basic mechanism of gbr
Basic mechanism of GBR
  • Prevention of fibroblasts filling the defect
  • Prevention of contact inhibition by heterotophic cell interaction
  • Exclusion of cell-derived soluble inhibitory factors
requirement of gbr barrier membrane
Requirement of GBR barrier membrane
  • Biocompatibility & safety
  • Cell occlusiveness
  • Space-making ability
  • Tissue integration
  • Clinical manageability & cost effectiveness

- by Teparat T et al. 1998

consideration of selecting membrane
Consideration of selecting membrane
  • The creation & maintenance of sufficient space underneath the barrier is an important factor for a successful results
classification of barrier membrane
Classification of barrier membrane
  • Nonresorbable membrane
  • Resorbable membrane
nonresorbable membrane
Nonresorbable membrane
  • Expanded polytetrafluoroethlene ( e-PTFE )

- Goretex

  • Nonexpanded polytetrafluoroethlene

- Tef Gen-FD

nonresorbable membrane1
Nonresorbable membrane
  • Titanium-reinforced expanded

polytetrafluoroethlene

  • Titanium membrane with microperforation

- FRIOS®Bone shield

resorbable membrane
Resorbable membrane
  • Collagen barriers

- Bio-Guide, Bio-Mend, Colla Tape

  • Synthetic polymers

- Vicryl Mesh, Resolut, Resolut XT

resorbable membrane1
Resorbable membrane
  • Biologically active membrane:

Platelet-rich plasma

  • Other barrier materials

- Capset, Lambone

characteristics of titanium membrane
Characteristics of titanium membrane
  • Mechanical property of rigidity
  • Smooth titanium surface with laserbeam-derived microperforation
  • Lateral marginal slit for fixation & shaping
advantage of titanium membrane
Advantage of titanium membrane
  • Effective fixation of grafting materials
  • Optimal mechanical stability
  • Easy & durable shaping
  • Maximum biocompatibility
  • Easier fixation by membrane tacks
disadvantage of titanium membrane
Disadvantage of titanium membrane
  • Increase in the number of exposure with mucosal perforation
  • Refrain from the placement of intermediate dentures
  • Technical sensitivity
purpose
Purpose
  • The purpose of this preliminary study is to present clinical results of titanium membrane used for GBR in implant dentistry
patients
Patients
  • Patients: 6 patients ( Since 2000.11 )
  • Sex: Male ( 4 ), Female ( 2 )
  • Age: 16-42years
results2
Results
  • 2 Patients: Uneventful healing of GBR site & retrieval of membrane after adequate healing period
  • 4 Patients: Membrane exposures after primary healing of mucosal incision
consideration of selecting membrane1
Consideration of selecting membrane
  • Most flexible membranes do not have enough rigidity & tend to collapse
  • More rigid nonresorbable membrane is needed
discussion
Discussion
  • The time between operation & exposure of the membrane is critical point
  • The rigidity of the titanium membrane leads to an increase in the number of exposure
conclusion
Conclusion
  • The rigidity of titanium membrane makes the barrier able to maintain space
  • Careful soft tissue management & avoid directing loading by intermediate denture is essential to prevent wound dehiscence
ad